| NPI | 1669934451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY GUESS PETERSEN Courtney Guess, Lcsw 512-730-0181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2019-04-02 |